Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
Youth Should be Served
December 26, 2013
A half-century ago, youth sports were not well organized. Children directed most of their own games, playing each sport in its season, moving from touch football in the side yard to basketball in the driveway to baseball in the vacant lot where an apartment building now stands. They walked or rode their bikes to the venues, they brought their own equipment, they chose up sides and they agreed upon the playing rules and ground rules.
Even if young people played on a community team, they spent more time in pickup games on makeshift fields, courts and diamonds than they did in uniforms at the groomed settings of the formal youth league games.
Gradually, the leagues multiplied and the ability groupings stratified. Elite teams were created consisting of the more talented kids, who were really just more mature for their age; and they were provided with the most games, the longest trips and the largest trophies. It didn’t take long for the other players to feel second class and to drop out of one sport or all sports. In time, even some of the “good” players succumbed to overuse injuries and emotional burnout.
By the time most students reached the earliest grades for school sports, many had already found different ways to spend their time. It is often cited and well-documented that, today, 80 to 90 percent of all youth who ever started playing organized sports have stopped doing so by age 13. Before high school.
So it occurs to me that school districts should have both altruistic and selfish reasons to rethink their approach to junior high/middle school sports, which is now to engage students too late and offer them too little. Schools might be able to provide a better experience for the youngsters and create an earlier and stronger relationship with the philosophies of educational athletics at the junior high/middle school level, and that ultimately will strengthen high school athletic programs.
This pursuit will take great care in order to assure that schools themselves do not make the same mistakes we have seen in overzealous youth sports programs. We will have to find the balance where multi-sport experiences are encouraged so middle school students can experiment with new sports and discover what they might really like and be good at, while at the same time provide enough additional contests that interscholastic programs are a more attractive option than non-school programs that may always allow more contests than school people will allow within an educational setting.